{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:39:45Z","timestamp":1760060385913,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Backgrounds: Most out-of-hospital cardiac arrest (OHCA) survivors are comatose due to hypoxic ischemic brain injury. Targeted temperature management (TTM) is the only evidence-based neuroprotective intervention for this condition; however, the optimal implementation of TTM has yet to be determined. The concept of high-quality TTM has been proposed to improve patient outcomes, but its clinical impact has not been thoroughly evaluated. This study investigates whether adherence to high-quality TTM is associated with improved neurological outcomes and survival among OHCA patients. Methods: This retrospective analysis used data from the Korean Hypothermia Network Prospective Registry 1.0, including 1060 adult OHCA patients treated with TTM at 33 \u00b0C between 2015 and 2018. High-quality TTM was defined as follows: temperature variability during maintenance within \u00b11.0 \u00b0C, maintenance duration \u2265 24 h, rewarming rate \u2264 0.5 \u00b0C\/h, and post-TTM fever control (temperature &lt; 38.5 \u00b0C). Patients were classified into high- and low-quality TTM groups. The primary outcomes were survival and neurological status (CPC ranging from 1 to 2 indicated a good outcome) 6 months after cardiac arrest (CA). Results: Of the 1060 patients, 491 (46.3%) received high-quality TTM. Compared with the low-quality TTM group, the high-quality TTM group had higher rates of survival (44.6% vs. 36.4%, p = 0.006). Multivariate analysis revealed that high-quality TTM was independently associated with survival (OR 1.802, 95% CI: 1.171\u20132.773) and good neurological outcomes (OR 1.748, 95% CI: 1.102\u20132.770). Conclusions: High-quality TTM is associated with improved survival and better neurological outcomes in OHCA patients. Standardizing TTM delivery on the basis of quality metrics may increase its effectiveness in clinical practice.<\/jats:p>","DOI":"10.3390\/jcm14165898","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T15:19:02Z","timestamp":1755789542000},"page":"5898","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-Quality Targeted Temperature Management After Cardiac Arrest; Results from the Korean Hypothermia Network Prospective Registry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1818-4667","authenticated-orcid":false,"given":"Hyo Jin","family":"Bang","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6709-7703","authenticated-orcid":false,"given":"Chun Song","family":"Youn","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3571-9448","authenticated-orcid":false,"given":"Byung Kook","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University Hospital, Chonnam National University of Medical School, 42, Jebong-ro, Donggu, Gwangju 61469, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5549-1148","authenticated-orcid":false,"given":"Sang Hoon","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyo Joon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ae Kyung","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji-Sook","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3141-9413","authenticated-orcid":false,"given":"Soo Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Eunpyeong St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyu Nam","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In Soo","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, KEPCO Medical Center, 308, Uicheon-ro, Dobong-gu, Seoul 01450, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Korean Hypothermia Network Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1007\/s00134-004-2425-z","article-title":"Mode of death after admission to an intensive care unit following cardiac arrest","volume":"30","author":"Laver","year":"2004","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1007\/s00134-013-3043-4","article-title":"Intensive care unit mortality after cardiac arrest: The relative contribution of shock and brain injury in a large cohort","volume":"39","author":"Lemiale","year":"2013","journal-title":"Intensive Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: Adult Basic and Advanced Life Support 2020 American Heart 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